Subclinical left ventricular disfunction in obese children: are we late?

ABSTRACT Aim Longitudinal global strain (LGS) is reduced in obese patients with normal ejection fraction of the left ventricle. TAPSE/PAPS ratio, recently described, may be a step forward a more efficient RV function evaluation. There are still few publications in the application of these methods in pediatric patients. Methods This case-control study compared 104 children aged 5-18 years between October 2017 and February 2019, 52 obese children with body mass index (BMI) > +2 SD, and 52 matched controls. They were screened for other cardiovascular risk factors like insulin resistance or hypercholesterolemia. A complete echocardiography including standard and functional parameters was performed. Results We found that obese children presented poor systolic function (LGS −15,90 ± 3,84 %) in comparison with non-obese children (−19,44 ± 5,75 %, p=0,001). LGS correlated positively with body mass index (BMI). Standard echocardiography also revealed cardiomegaly and hypertrophy. TAPSE/PASP ratio correlated negatively with triglycerides levels (β −0,402, p=0,014). Diastolic function was poor in those with HOMA-IR (β −0,375, p=0,016) and hypertriglyceridemia (β −0,375 p=0,024). Conclusion We think that is necessary to perform a standarised cardiovascular evaluation in obese children for early identification of subclinical dysfunction especially in those with insulin resistance and dyslipidemia